Drama Activation

I'm often asked how many of the calls we get are legitimate. That is, how many people that call 911 actually NEED an ambulance? If pressed, I'd estimate that somewhere between 40 and 50 percent of our calls are true medical emergencies. The other 50 to 60 percent? Everything from nursing homes no longer wishing to deal with a difficult patient, to law enforcement officers covering their asses by calling an ambulance for the newly arrested person with the sudden onset of vague symptoms (Known in the business as "acute incarceritis" or "handcuff allergy".), to patients that just want someone (Not necessarily us.) to pay attention to them. The third group is by far the largest.

Chest pain and/or difficulty breathing are the afflictions of choice for the dramatic. Those two things don't necessarily produce visible symptoms, and thanks to years of public education, everybody takes them seriously. OK, almost everybody. To EMS providers, all calls are assumed to be bullshit until proven otherwise. We can usually tell in less than a minute or so if your complaint is real or not. We'll still do a thorough exam, of course. We ARE professionals, after all. But the whole time we're checking you out, we probably already know what the results are going to be. So seriously, don't try to bullshit us. We can see right through it. If you manage to fool us, you'll never fake out the cardiologist, and very few of them have a sense of humor to start with. Plus, they bill more than we do, and if we think you're faking it, by the time a doctor sees you, we've already told them you're probably not sick. You might wind up getting a very large bill for little more than sitting all by yourself in a room with no TV for six hours.

Fake seizures are also popular, and far more entertaining for us. We've been known to applaud a particularly good performance. REAL seizures produce some predictable symptoms, so if we don't see those, we assume it's not actually a seizure. Little hint- if you're trying to fake a seizure, wet your pants. Nobody ever thinks to do that, and it's actually relatively common in a real seizure. If you can arrange to lose control of your bowels as well, I'd probably go ahead and give you the valium, just as a reward for authenticity. Plus it'll keep you from doing it again, at least until I get you to the hospital and the drugs wear off.

Fainting or being "found" unconscious is popular among the younger melodramatic patients. It's not all that uncommon in the actually sick, and the number of things that cause it is astronomical, so finding a 16 year old passed out doesn't necessarily register as obviously fake. Most of the time. But when it's obvious, it's REALLY obvious. Again, we can tell if you're truly out in less than a minute. Flickering eyelids and purposeful movement are dead giveaways. If you try to hold your eye closed when I go to check your pupils, I know it's fake. Really unconscious people tend to go totally limp and don't resist being moved. So if you fake unconscious, we'll find out. The common way to do this is to check your reaction to noxious stimuli. Meaning pain. Like a knuckle rubbed on your sternum. Or the same knuckle on the mastoid bone. Or take the first joint of the pinky finger, bend it down in it's natural direction, and squeeze hard. Hurts like hell if you do it right, and can also be used to unobtrusively encourage troublesome spectators on a scene to go find something else to do for a while. If you insist on playing this little game out, it's entirely possible we're going to cut your clothes off you so we can do a thorough exam. Someone that's legitimately unconscious for an unknown reason has to be assumed to have a hidden traumatic injury until we've definitely ruled it out. That means we have to go hunting, which means it's scissors time. Unless you're wearing a down jacket. EMS Rule #2- Never cut a down jacket unless you absolutely have to. Cut one, and I have, and you'll be sweeping feathers out of the ambulance for weeks afterward. Don't worry, we WILL cover you up eventually. And no, we don't have to pay for or replace what we cut. You probably should have thought of that.

I don't know why people call 911 expecting sympathy. In the paramedic dictionary, "sympathy" is nothing but the word that appears between "shit" and "syphilis".